Individual
ALBERT YUSUPOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
30 PROSPECT AVE, DEPARTMENT OF ANESTHESIOLOGY, HACKENSACK, NJ 07601-1915
(551) 996-2419
(551) 996-3962
Mailing address
30 PROSPECT AVE, DEPARTMENT OF ANESTHESIOLOGY, HACKENSACK, NJ 07601-1915
(551) 996-2419
(551) 996-3962
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB09828400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2013
Last updated
07/07/2016
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